Coping and Depressive Symptoms in Individuals with Multiple Sclerosis

It is estimated that 40% to 60% of individuals with Multiple Sclerosis (MS) may be clinically depressed (Biogen, 2002; Chwastiak et al., 2002; Parcells, 2003; Ranger, 2002). Feeling depressed may be inevitable when a person is initially diagnosed with MS. Over time, however, depression may hinder the person's ability to cope with the specific challenges of MS and diminish day-to-day functioning. Although extensive research has examined the prevalence of depression among individuals with MS, few researchers have examined the relationship between coping style and depression in individuals with MS. The goal of the present study was to identify the coping styles and other factors that may be associated with depressive symptoms among individuals with MS. By identifying effective coping strategies for combating depression and by identifying the type of coping style that may predispose an individual with MS to depression, mental health professionals and medical practitioners may be able to provide earlier and more effective intervention. The present study expands upon the preliminary research by Huffman and Kelley (2004) that examined relationships between depressive symptomatology and coping style in Relapsing Remitting MS clients of the Hampton Roads Chapter of the National MS Society (NMSS). Specifically, the present study examined depression in individuals with different stages of MS as related to factors such as whether the individual was in a significant personal relationship, length of time since the initial diagnosis, use of anti-depressants, and gender. Consistent with previous research, 54'/0 of the participants reported clinical levels of depressive symptomatology. The following variables significantly predicted depression: Emotion-oriented coping, Social Diversion coping, Relapsing Remitting form of MS, Primary Progressive form of MS, and use of antidepressants. Higher levels of Emotion-oriented coping (e.g., more emotion-focused coping strategies), the greater the likelihood for depression, (Odds Ratio = 1.11). In addition, respondents who reported higher levels of Social Diversion coping (e.g., coping via increased social activities) were less likely to meet criteria for depression (Odds Ratio = .89). In addition, the Relapsing Remitting form of MS was found to be a significant predictor of depressive symptomatology. Primary Progressive form of MS also predicted greater likelihood of depression (i.e., those with Primary Progressive MS were more likely to be depressed than individuals with other forms of MS, Odds Ratio = 3.66). In addition, individuals taking anti-depressants were more likely to be depressed (Odds Ratio = 2.57). implications are that multiple variables may be involved in the high rates of depression among those with MS. Specifically, Emotion-oriented coping strategies may be less effective for combating depression in individuals who have been diagnosed with MS for an average of 11.6 years. In addition, depression appears to be related both to the initial (i.e., RR MS) and to the most severe stage of MS (i.e., PP MS). In addition, it appears that individuals with MS who are depressed are more likely to be taking antidepressant medication. However, the degree to which anti-depressants may be effective for individuals with MS is uncertain.